SSRI Antidepressants May Pose More Risks For Seniors Than Alternatives

Selective serotonin reuptake inhibitor (SSRI) antidepressants have been linked to cardiac birth defects, increased risks for Autism Spectrum Disorders (ASDs), and even breast and ovarian cancers. Now, a new study has found that SSRIs such as Prozac (fluoxetine) and Effexor (venlafaxine), might not be the most effective or safest choice when treating seniors for depression.

According to Health Day News, SSRIs might pose the potential for more side effects than older antidepressants. The new study, conducted in Britain, appears in the August 2 issue of the journal, BMJ.com, and revealed that older medications known as tricyclic antidepressants could offer safer alternatives for people over the age of 65.

“The choice of class of antidepressant is a complex decision, and some evidence is still lacking to help with that choice in older patients,” said study author Carol Coupland, associate professor of medical statistics at the University of Nottingham, reported HealthDay News. “Low-dose [tricyclic antidepressants] may be more suitable in frail elderly patients at increased risk of falls and fracture,” Coupland added.

SSRIs also include Celexa (citalopram), Paxil (paroxetine), and Zoloft (sertraline), which are popularly used to treat depression in the senior population; however, only a few clinical trials have reviewed SSRI safety and efficacy in this group, HealthDay News reported.

Coupland’s team reviewed prescription data on over 60,000 patients aged 65 to 100 who were recently diagnosed with depression and found that most patientsâ€”89 percentâ€”received one or multiple antidepressant prescriptions. Of these, said HealthDay News, 57 percent received one SSRI prescription and 31 percent received one tricyclic antidepressant; the remainder were taking other antidepressants.

The study found that seniors taking SSRIs had an increased risk of dying, suffering a stroke, falling, breaking a bone, or having seizures versus seniors not on an antidepressant. Specifically, said HealthDay News, in one year, 10.6 percent of seniors taking an SSRI died as opposed to 8 percent on tricyclics and 7 percent not taking an antidepressant. Over 11 percent of those on other antidepressants died.

Effexor, Remeron (mirtazapine), and Desyrel (trazodone) revealed the greatest risks, which were especially high in the first month after starting and in the month following discontinuation of the drug, said HealthDay News.

Since 2005, information has been emerging that certain SSRIs may also cause birth defects, including cardiac (heart), pulmonary (lung), neural-tube defects (brain and spinal cord), craniosynostosis (abnormally shaped skull) infant omphalocele (abdominal wall defects), club foot (one or both feet turn downward and inward), and anal atresia (complete or partial closure of the anus). But, some older generation antidepressants are not without their risks, such as for increased likelihoods of cardiovascular disease (CVD) and interference with breast cancer treatments, causing patients to relapse and die.